Sen. Landrieu, the Public Option, and Free Lunches

Sen. Mary Landrieu, a relatively conservative Democratic U.S. senator from Louisiana, apparently is not on board for direct implementation of a public option, but would support a trigger to implement one automatically if certain conditions were not met (e.g., if health insurance prices exceeded a certain level after some amount of time had passed).

Within this context, Landrieu was asked in an MSNBC television interview why she opposed a public option when it enjoyed high support in public-opinion polls. Here is her answer (as transcribed by a Daily Kos discussant):

"I think that when people hear 'public option,' they hear 'free health care.' Everybody wants free health care. Everybody wants health care they don't have to pay for. The problem is that we as government and business have to pick up the tab, and as individuals. So I'm not at all surprised that the public option has been sold as free health care. But there is no free lunch."

(Here is a link to where the video is available.)

Landrieu makes a fair point. In fact, it's a point that can be examined empirically by comparing polls whose question-wordings do or do not explicitly mention that consumers would have to pay for (or purchase, etc.) a health-insurance policy under the public option, if they wanted to join such a program. If the polls whose wordings do not mention the pay aspect (i.e., that possibly imply the public option is a "free lunch") tended to be the only ones that generated majority (or at least plurality) support, then perhaps Landrieu would have a point.

One batch of polls that quickly shoots down the Landrieu thesis is the set of state-specific surveys commissioned by Daily Kos and conducted by Research 2000. The DK/R2K polls have consistently included the phrase "...that anyone can purchase," and even in moderate-to-conservative states such as Arkansas, Kentucky, and Montana, higher percentages of respondents have expressed support for a public option than opposition toward one.

One national poll that has used the "purchase" terminology when assessing support for the public option is that by The Economist/YouGov ("Do you favor or oppose having a 'public option' which would allow individuals to purchase health insurance coverage from the government?"). Although this poll comes out weekly, it does not always ask about the public option. I have plotted support levels for the last five Economist/YouGov polls, below (original reports: July 26-28, Aug. 16-18, Aug. 23-25, Sept. 13-15, Oct. 11-13).


Again, support for a public option seems pretty solid, even when the polling item makes clear that a public option is not a "free lunch" and instead would have to be purchased by interested individuals.

There is one area where I think Sen. Landrieu's claim may have some merit, however. It is true that polling results showing "super-high" (59-77%) support for the public option have not used question-wordings that make clear the program would entail a cost.